It is widely know that if retinopathy and specifically diabetic retinopathy are not "duly" detected and controlled through medical interventions, they can progress into a proliferative retinopathy and cause significant decrease in visual acuity and blindness. It is estimated that in 2008, approximately 24 million in the U.S. [1] and 194 million people worldwide suffered from diabetes (according to University of Calgary, March 17, 2009,). Nowadays, diabetic retinopathy accounts for 5% of the world's blindness, according to the World Health Organization [2]. Early detection of diabetic retinopathy is essential to averting permanent ocular damage and visual impairment. To facilitate early detection and diagnosis of retinopathy, Physical Optics Corporation (POC) proposes to develop a new high-speed Adaptive Retina-tracking Optical Coherence Tomography (ART-OCT) system based on spectral domain optical coherence tomography (SDOCT) uniquely combined with high-speed adaptive retina tracking and aberration compensation. The system integrates a ferroelectric liquid crystal (FLC) rapid-scanning optical delay (RSOD) line, with high-resolution adaptive optics aberration correction by means of a microelectromechanical (MEMS) deformable mirror, a Shack-Hartmann wavefront sensor, and fast retina tracking by means of optoelectronic joint Fourier transform correlation. The novel ART-OCT design will produce a robust, compact, and simple-to-use system for fast noninvasive in-situ and in-vivo tomographic imaging of the retina with high contrast and high 3D resolution (i.e., transverse resolution of 2 5m and an axial resolution of <5 5m), as well as image stabilization and enhancement which can be potentially used in morphological discrimination and analysis of abnormalities such as retinal microaneurysms, retinal edema, hard exudates. As a result, ART-OCT enables timely/early detection of sight- threatening retinopathy for laser photocoagulation and thus it avoids the risks of subsequent severe visual lesion and permanent visual impairness. In Phase I, POC will determine the physical and performance specifications of the integrated ART-OCT system, such as transverse and axial resolution, sensitivity, and imaging and tracking speed. Feasibility of the ART-OCT technology will be demonstrated by designing, fabricating, and testing a bench-top ART-OCT prototype. In addition, given the existing collaboration with UCLA on similar projects, POC drafts similar IRB procedures for preliminary clinical tests to be implemented in Phase II. POC plans to develop a fully operational ART-OCT prototype in Phase II and demonstrate its capabilities in 3D imaging of microscopic blood vessels in diabetic retinopathy. Successful completion of the project will lead to a solution for in-situ and in-vivo early-stage diagnosis of retinal microaneurysms and other abnormalities with diameters of 10 to 100 microns. This enhanced precision translates to early-stage levels of 21-35 and below based on Retinopathy Levels, compared with the existing solutions with retinopathy levels of 35 and above (see Table 2-1). PUBLIC HEALTH RELEVANCE: The ART-OCT provides high-speed eye tracking, in-depth retina rapid-scanning and image enhancement capabilities that overcome the limitation of current (diffraction-limited) ophthalmological retina imaging systems due to natural loss of spatial resolution caused by the optical distortions, eye aberrations, and eye movement. Therefore, the proposed system provides a high 3D resolution comparable to the size of individual cells and hence will represent a breakthrough in efficient, noncontact, accurate, and noninvasive techniques for early diagnosis and monitoring of diabetic retinopathy and other vascular diseases of the retina and choroids.